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9605 Jefferson Hwy River Ridge LA 70123-2550 | |
(504) 738-1604 | |
Not Available |
Full Name | |
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Speciality | General Practice |
Location | 9605 Jefferson Hwy, River Ridge, Louisiana |
Authorized Official Name and Position | Katherine Cardwell (AVP) |
Authorized Official Contact | 5048427208 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1514 Jefferson Hwy New Orleans LA 70121-2429 Ph: (504) 842-4000 | 9605 Jefferson Hwy River Ridge LA 70123-2550 Ph: (504) 738-1604 |
NPI Number | 1417409566 |
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Provider Enumeration Date | 10/25/2016 |
Last Update Date | 10/25/2016 |
Identifier | Type | State | Issuer |
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1417409566 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |